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Epidemiology Etiology
Pathophysiology Pathophysiology
- Substernal pain and pressure may radiate to - Left ventricular hypertrophy initial response
arms, jaw teeth, back - LV hypertrophy, resistance - cardiac
- Occurs during physical exertion or emotional output, pulmonary HPN, myocardial ischemia
stress
P.E
- Resolves with rest stable angina
- Occurs at rest/not resolves at rest unstable - Angina, syncope, dyspnea - worst prognosis
angina -> pending MI - Midsystolic ejection murmur
- Cardiomegaly, CHF
P.E
- Pulsus tardus et parvus delayed impulse at
- Peripheral vascular disease, diminished pulses carotid
- Ventricular failure, cardiomegaly, CHF
Dx
- S3 or S4 murmur of mitral regurgitation
A decrease in aortic
- Echocardiography valve area from normal
Dx
- Cardiac catherization 3 or 4 cm to <1 cm
- ECG ischemia, old infarct signifies severe disease
Tx
- Xray enlarged heart or pulmonary congestion
- Thalium imaging - Symptomatic aortic valve replacement
- Angiography gold standard in identifying - Asymptomatic surgery >medical
coronary Artery
Tx
AORTIC INSUFFICIENCY
- Coronary bypass internal mammary artery or
saphenous Etiology
- Balloon angioplasty & stent displacement - Rheumatic fever, CT disorders Marfan &
Ehlers-Danlos syndromes, endocarditis, aortic
dissection, trauma
Pathophysiology
P.E
Dx echocardiography
Tx replacement surgery
MITRAL STENOSIS MITRAL REGURGITATION
Etiology/Epidemiology Etiology/Epidemiology
Pathophysiology Pathophysiology
P.E P.E
Dx Dx
Tx Tx